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Academic detailing implementation: support and practical steps

This presentation by Dr. Michael A. Fischer provides support and practical steps for implementing academic detailing in healthcare settings. It covers the challenges, benefits, and flexible uses of academic detailing, as well as the components of a successful program. The presentation also discusses assessing program needs, developing and producing detailing materials, hiring and managing detailers, training detailers, and measuring program effectiveness. It concludes with information on the National Resource Center for Academic Detailing and ongoing support resources.

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Academic detailing implementation: support and practical steps

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  1. Academic detailing implementation: support and practical steps Medi-Cal Annual AD Meeting | October 12, 2017 Michael A. Fischer, M.D., M.S. Director, National Resource Center for Academic Detailing Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital | Harvard Medical School

  2. Sources of Support • NaRCAD is supported by a grant from the Agency for Healthcare Research and Quality (AHRQ). • My current research projects are funded by AHRQ, FDA, PCORI, NIH and Surescripts. • I consult for Alosa Health, a non-profit that supports academic detailing programs. I do not accept personal compensation of any kind from any pharmaceutical companies, health insurers or device manufacturers. • DoPE accepts occasional unrestricted research grants from drug companies or health insurance companies to study specific drug safety and utilization questions.

  3. Current Challenges

  4. Economic Pressures Increasingly, clinicians struggle with: Formularies Prior authorizationrequirements Algorithms Marketing

  5. What Clinicians Value Academic Detailing (AD) offers: • Engagement • Sense of purpose • Ability to reinvigorate primary care Respect Professionalism Mastery

  6. Increasing Demand for AD • System-wide quality improvement • Established chronic disease management • New opportunities • Threats • Capacity building for sustainability

  7. Flexible Uses of AD • Improving Knowledge • Changing Treatment • Advancing Patient Education • Increasing Diagnosis and Screening • Expanding Use of Complementary Resources

  8. AD in Multifactorial Interventions • Intervention targets will vary for different clinical problems • AD can play a key role when interventions require: • Clinician engagement • Education on best evidence • Behavior change • AD can complement other elements of an intervention: • Practice facilitation • Health IT • Financial incentives

  9. Developing Successful AD Programs • Context is critical; each site has different challenges • Building capacity in organizations creates sustained opportunities • What are the components of a successful program?

  10. Elements of a Successful Program • Identifying gaps in care • Defining intervention goals • Recruiting and training detailers • Providing evaluation and assessment • Building capacity and sustainability

  11. Assessing Program Needs • Clinical goals • Organizational capabilities and experience • Health needs in target population • Gaps between current practice and best practice • Evaluate existing data

  12. Developing and Producing Detailing Materials • Compilation of evidence base • Analysis and summary by relevant experts • Identification of key changes needed • Synthesized into educational materials • Relevant, useful information for clinicians and patients • Clearly and effectively communicated • Retained for future reference

  13. Hiring and Managing of Detailers • Developing job description • Successful detailer profiles • Full-time hires versus consultants • Establishing goals • Monitoring performance • Building team morale

  14. Training of Detailers • Principles of Social Marketing • Structuring of a visit • Communicating messages effectively • Actively listening and engaging clinician in conversation • Delivering messages under a variety of circumstances • Gaining commitment to action • Clinical Content • Customized for specific interventions

  15. Measuring Program Effectiveness • Change in patterns of care • Prescribing data, other sources • Cost-effectiveness of detailing effort • Potential impact of modifications to program • Impact on expenses outside of network

  16. Dedicated National and Global Network of Partners • Specialized Techniques Training Courses • International Conference on AD • Virtual Resources, Tools and Best Practices Sharing

  17. NARCAD: Ongoing Support

  18. Resource Expansion in 2017

  19. Media Highlights

  20. Success by Strategic Partnership

  21. Stories from the Field

  22. Clinical Topics our Partners are Working On

  23. “This was the best and most efficient healthcare-related training course I’ve been to.” -NaRCAD Training Alumnus

  24. Website Address: narcad.org Email Address: narcad@partners.org

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